The Center for Clinical Epidemiology and Biostatistics (CCEB), the Leonard Davis Institute (LDI), and the Center for Experimental Therapeutics (CET) of the University of Pennsylvania School of Medicine (SOM) propose an innovative research training program, specifically designed to develop further our traditional training strengths in epidemiology and health services research, while building strength in patient-oriented research (POR). The CCEB and the LDI already have a track record of MS degree training in clinical epidemiology and health services research, emphasizing investigations of disease etiology, prognosis, prevention, and early detection, treatment, and clinical economics. The SOM has also supported the establishment of an introductory course in POR for clinicians, which has now entered its second year. Furthermore, the CET was established to foster cross-disciplinary training of physician-scientists well versed in both basic science and POR. Finally, the Department of Medicine has established the Clinician-Investigator Pathway (CIP), in which clinical training is accelerated to permit an expanded period of research training in any of these three fields. The NIH-funded General Clinical Research Center (GCRC) also represents an integrative resource that is presently used extensively by the CCEB, the CET, the LDI, and by the introductory POR course. With support from this Award, some potential trainees, although not all, will enroll initially in the introductory course in POR. Those who wish to pursue further training could then enter one of three tracks leading to the MS degree: epidemiology, health services research, or POR. The first two tracks are well established but require support to expand and integrate with POR; the third track will be developed during the course of this award. The MS tracks comprise a series of core courses, of which some will be track-specific; plus elective courses; extensive independent readings; attendance at and participation in a new series of integrative Clinical Research seminars as well as the independent seminars sponsored by the CCEB, the CET, and the LDI; plus the completion of an independent research project. The program is designed to: (1) provide a comprehensive understanding of the performance of clinical research, (2) provide research experience with mentors in the three disciplines of clinical research; and (3) develop further the interactions between faculty and trainees in the three disciplines. Strengths of the proposed program include the long history of successful research training programs in the CCEB, the LDI, and the CET; the collaborative links that have already been forged among the three programs; the exceptional track record of the SOM in NIH-supported research and training; the preliminary experience with the introductory course in POR; the institutional emphasis on the development of expertise in Clinical Research; and the comprehensive course offerings and research programs that are available to trainees. In addition, the availability of resources such as the GCRC, extensive, newly developed laboratories, large databases available for research projects, a range of specialized analytic capabilities available and the commitment, expertise, and unusually complementary track records of the P.I. and co-PI s in the three distinct aspects of Clinical Research targeted by this program represent particular features of this proposal.